Bilingualism and Children with Language and/or Cognitive Disabilities

Dr. Elizabeth Kay-Raining Bird (Ph.D. Madison, Wisconsin) is a Professor in the School of Human Communication Disorders at Dalhousie University in Halifax, Nova Scotia, Canada. Her research and teaching is in the area of child language development and disorders, with a particular focus on children and adolescents with Down syndrome. Her publications and presentations have focused upon a variety of topics including: cultural and linguistic diversity, language and literacy development, and the effectiveness of speech, language and literacy interventions. Elizabeth is a speech-language pathologist, certified with both the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA) and the American Speech-Language-Hearing Association (ASHA). She is currently the President of the Speech and Hearing Association of Nova Scotia (SHANS).

As Annick DeHouwer stated in 1999, “Bilingualism is most often a necessity, not a choice”. What this means is that many children live in environments that require them to speak and understand two languages. This is true whether or not a child has a language, or cognitive impairment. The need to be bilingual cuts across disability boundaries.

Unlike children with typical development, however, parents of children with language and/or cognitive disabilities are often told by professionals to expose their children to only one language, even when their child needs to learn two languages to communicate fully and effectively in their everyday lives (e.g., Paradis, 2007; Thordardottir, 2002). I believe that this is not an appropriate recommendation, for two reasons. First, it will isolate the child from important communicative contexts and deny the child the social benefits of being bilingual. Second, bilingual parents may find speaking the chosen language, or only one language, uncomfortable and unnatural. This, in turn, may negatively affect the quality parents’ ability to facilitate language development in their children through their interactions. Instead, I feel it is critical to help families optimize bilingual development for their children with disabilities who need to learn two languages.

The research baseMost developmental research on bilingualism involves typical children. While recent bilingual research has begun to focus upon individuals with language and/or cognitive disorders, most involves children with either language, but not cognitive, difficulties–children who are often referred to as Specifically Language Impaired (SLI), or children with Down syndrome. Other populations such as autism or Williams syndrome have been largely ignored. Therefore, when we seek to understand bilingualism in children with disabilities, we must often infer from related bodies of literature. In this article I will first provide a brief overview of how variable bilingual individuals are, followed by a discussion of bilingual development for typical learners, children with SLI, and children with Down syndrome. In each section I will discuss implications for children with language and/or cognitive disabilities in general, and will end with tentative clinical conclusions.

Not all bilingual experiences are the same
There is a lot of variability in the experiences of bilingual individuals, regardless of whether they have a language or cognitive impairment or are learning language typically. One important factor that differentiates bilingual speakers is timing—that is, when each language was learned. Simultaneous bilinguals (or bilingual first language learners) learn both their languages at the same time and essentially from birth. In contrast, sequential bilinguals learn one language first and then learn their second language. Other important distinctions include where the languages are spoken (e.g., home, school, community), who speaks to the child in each language, which languages are spoken (e.g., French and English), how similar the languages are that are spoken (e.g., French and English are more similar than French and Chinese), and the relative status each language holds in society (i.e., are English and French valued equally in the community?). Frequency of exposure is another factor critical to consider. Children will understand and speak a language they hear and use often, better than a language they hear and use infrequently (Pearson, Fernandez, Lewedag, & Oller, 1997).

We do not yet know how best to support bilingual development. For simultaneous bilinguals, many have suggested using a one parent one language strategy, meaning that each parent should choose a language to speak to their children. This strategy, however, may be difficult for some families to implement. As well, just because a parent speaks a language to their child does not mean that the child will respond in that language. Indeed, in the case where the home language is a minority language, children may often respond in the majority language. Thus, there is no clear evidence that the one-parent-one-language strategy works better than alternative strategies for speaking two languages in the home (De Houwer, 2007; Thordardottir, 2006). One important rule of thumb is to ensure that any bilingual child experiences each language frequently. This may be particularly important for a child who has language learning or cognitive difficulties, as they often require additional models to acquire a particular word or linguistic structure. A second rule of thumb is to provide high quality input in interactive, naturalistic contexts, regardless of the language being spoken. General language stimulation principles (such as modeling, imitating, recasting) will be useful regardless of how many languages are being learned.

Bilingualism and typical developmentSimultaneous bilinguals with adequate exposure frequency will acquire two languages in approximately the same time frame that monolingual children acquire one language (e.g., De Houwer, 2009; Genesee, 2006; Genesee, Paradis & Crago, 2004). That is, major milestones, such as the emergence of first words, will occur at approximately the same time. This does not mean that bilingual development looks just like monolingual development. It does not. Young simultaneous bilingual children will have smaller vocabularies than monolingual children of the same age when you look at each of their languages separately. But, when you combine the words they know in both languages, bilingual children will have vocabularies that are often similar in size or sometimes even larger than monolingual children’s (Pearson, 1998; Pearson, Fernandez & Oller, 1993; Pearson, et al., 1997). This learning profile has implications for children with language and cognitive disorders. First, these children will have language learning problems whether they learn one or two languages. Second, bilingual children with language learning disorders will exhibit problems in both their languages, but the types of problems they experience will depend upon the specific structures they need to learn, or typology, of each language. Third, depending upon how frequently each language is heard and used, children may have one language that they speak better (i.e., dominant) than the other. Finally, children who are bilingual with language and cognitive disorders will develop somewhat differently from children who are monolingual with language and cognitive disorders. This is natural.

Another difference between bilingual and monolingual children is that bilingual children experience language transfer, where aspects of one language impact their understanding or use of the other language. Language transfer can have a positive impact on language learning, as when a child uses their knowledge of a French word (e.g., “mal”) to learn an English word (e.g., “malevolent”). It can also lead to errors in bilingual children’s production, as when a child uses a syntactic structure from French when speaking English (e.g., “Me, I am going.”). We would expect language transfer to occur in children with language and cognitive impairments as well as typically developing children.

Sequential bilinguals have different developmental profiles than simultaneous bilinguals. First, they do not always become fluent in their second language (L2). Factors that influence L2 fluency include how young they are when exposed, how frequently they are exposed, how rich the language environment is, parent’s educational levels, willingness to use the language, and, for older children who have chosen to learn a second language, how motivated they are to learn (Paradis, 2007b). Second, their first (home) language (L1) can become their weaker language over time, especially in contexts where it is not used frequently and is a minority language. The implication for all children, including those with language or cognitive disorders, is that the home language must be supported in order to maintain L1.

A consequence of bilingualism that has received considerable attention in the literature is enhancement of some metalinguistic skills. Metalinguistics is the conscious ability to think about and manipulate various components of language. One type of metalinguistic skill is word consciousness, defined as the “awareness of and interest in words and their meanings” (Graves, 2006). A bilingual child demonstrates word consciousness when he says, for example, “cat is chat in French”. Word consciousness is an early developing metalinguistic skill in bilingual children. Other metalinguistic skills that appear to be advanced in bilingual children are the ability to judge whether a sentence is grammatical and the ability to count the number of words in a sentence (Baker, 2006; Bialystok, 2001; Lazaruk, 2007). It is possible that metalinguistic abilities such as these can assist children in learning language, a possibility that may be particularly important for children with language learning difficulties. While this is a possible outcome, we currently know very little about metalinguistic consequences of bilingualism in children with language or cognitive disabilities.

Bilingualism and Specific Language Impairment
As stated, children with specific language impairment have language learning, but not major cognitive, disabilities. Research with this population has shown that, for each of their languages, simultaneous bilingual children with specific language impairment make the same type of errors as monolingual children with specific language impairment. For example, in English, both bilingual and monolingual children with specific language impairment have particular difficulty learning to use auxiliary (e.g., He is going) and copular (e.g., He is cold) and past tense (e.g., He walked) verb forms. In addition, when groups of bilingual and monolingual children with SLI of similar age are compared, they do not differ in the frequency of the errors they exhibit Paradis, Crago, Genesee, & Rice, 2003). Similarly, when groups of language-matched (i.e., mean length of utterance) bilingual children with typical development or specific language impairment are compared, they show similar error frequency and types in each of their languages (Paradis, Crago, & Genesee, 2006). The studies discussed in this section so far are of simultaneous bilinguals with SLI. While several studies of sequential bilinguals with SLI have been conducted, none to date have compared monolingual children with SLI to bilingual children with SLI, on either their L1 or L2 (Kohnert & Medina, 2009). Taken together, these findings suggest that simultaneous bilingualism is not detrimental to language learning in children with specific language impairment and that they can become successfully bilingual (Paradis, 2007). In addition, a bilingual child who has SLI will manifest that impairment in both of their languages, although the nature of the language difficulties they exhibit will differ across languages and will be defined by the typology of each language being learned.

Bilingualism and Down syndromeChildren with Down syndrome have cognitive impairments that vary from mild to severe in nature. Their cognitive impairments lead to general learning difficulties, as well as specific language learning problems; so, all aspects of language are delayed relative to their age. Despite considerable individual variability, research shows that monolingual children with Down syndrome as a group have an identifiable profile of language strengths and weaknesses (Chapman & Kay-Raining Bird, in press; Chapman & Hesketh, 2000). First, their understanding of language is usually better than their ability to speak it. This means that it can be hard to judge what a child with Down syndrome knows about language from what they say. Second, grammar is harder for children with Down syndrome to learn than vocabulary.

How do children with Down syndrome fare when learning two languages? First, they can become functionally bilingual (Woll & Grove, 1996) and even trilingual (Vallar & Papagno, 1993). Second, as one might expect, simultaneous bilingual children with Down syndrome show the same profile of strengths and weaknesses in both their languages that is found in monolingual children in their single language (Feltmate & Kay-Raining Bird, 2008; Kay-Raining Bird, Cleave, Trudeau, Thordardottir, Sutton, & Thorpe, 2005). Third, the dominant language skills of simultaneous bilinguals with Down syndrome are equivalent to the single language skills of monolingual children with Down syndrome of the same mental age (Kay-Raining Bird et al., 2005), so being bilingual does not disadvantage them in terms of language learning. And finally, simultaneous bilinguals with Down syndrome are learning to speak two languages, although how well they speak the non-dominant language can vary considerably and is related to factors such as frequency of input. Unfortunately, we have very little information about sequential bilinguals with Down syndrome to date.

Conclusions
More research must be conducted to help us understand the course of development of bilingualism in children with language and/or cognitive disorders and the factors that influence that development. For example, children with language and/or cognitive disorders must be studied in a larger variety of geographic locations and educational settings so that we can better understand the outcomes across the range of bilingual experiences that exist. Importantly, sequential bilingualism in children with language and/or cognitive disabilities must receive more attention. As well, a larger set of language measures must be studied. Despite the dearth of information, several conclusions and recommendations can be made:

Families must lead in making decisions regarding whether their children need two languages.

If a child with a language and/or cognitive disorder needs to know to languages, then the focus should be upon helping them learn the two languages. It is not appropriate to recommend that the input be reduced to a single language.

It is important to provide frequent and high quality input to children in each language they are learning.

For children with language and/or cognitive difficulties, speech-language pathologists and other professionals can help families identify successful language facilitation strategies.

If a child has a language and/or cognitive disorder, all languages they learn will be affected.

Bilingualism does not change the general profile of language strengths and weaknesses characteristic of children with language and/or cognitive disorders. If they are bilingual, however, this profile will manifest in both languages. For example, whether bilingual or monolingual, children with Down syndrome will be likely to have more difficulty learning grammar than vocabulary.

The particular language features that children with language and/or cognitive disorders have difficulty with will depend upon the typological characteristics of the language(s) they are learning.

De Houwer, A. (1999). Two or more languages: Some general points and practical recommendations. ERIC Digest (EDO-FL-99-03), U.S. Dept. of Education, Office of Educational Research and Improvement, National Library of Education, under contract no. ED-99-CO-0008.

Feltmate, K., & Kay-Raining Bird, E. (2008). Language Learning in Four Bilingual Children with Down Syndrome: A Detailed Analysis of Vocabulary and Morphosyntax. Canadian Journal of Speech-Language Pathology and Audiology, 32, 6 – 20.

Fidler, D.J., Hepburn, S., & Rogers, S. (2006). Early learning and adaptive behaviour in toddlers with Down syndrome: Evidence for an emerging behavioural phenotype? Down Syndrome Research and Practice, 9, 37-44.

Woll, B., & Grove, N. (1996). On language deficits and modality in children with Down syndrome: A case study of twins bilingual in BSL and English. Journal of Deaf Studies and Deaf Education, 1, 271 – 278.

8 responses to “Bilingualism and Children with Language and/or Cognitive Disabilities”

For a parent to have the necessary courage to stand up to hospital professionnals etc and say ‘no, I’m going to speak in my own language to my child’…it’s just so difficult.

I keep trying to get them all ‘on my side’ or at least to understand how a mother can feel about that, but their major concern is getting our son to catch up to a normal level of language so he won’t suffer so much academically etc (he’s just 5) . I can understand their viewpoint too.

It’s all very frustrating. I can’t tell them they’re not up-to-date with all the latest reserach as I’ll get their backs up and then our son won’t get all the help he needs.

I have worked in both medical and educational settings with young children and adults who have speech/language disorders. I’ve had an interest re: language intervention with people who live in a non-English speaking home environment. This is a great article. I’ve never felt that it is appropriate for me to suggest that a patient or a child change their language system to English. Although I’m not fluent in multiple languages, I have learned some Vietnamese, Spanish, German, Arabic, and Mandarin over my career. This occurred as a result of helping families of patients help their loved one communicate.
I believe that we need to remember that our therapy is supposed to be patient-centered. Learning a new language code to help someone requires increased effort, but phonetics and tape recorders offer a tecnological bridges. I’ve found the effort is an great investment re: effective results for our patients. For example, one man had a right cerebral hemisphere stroke while walking up a flight of stairs. He fell and sustained a brain injury in the left cerebral hemisphere. He was a successful businessman who spoke 4 languages! They included English, Itallian, Spanish, and Mandarin. Mandarin, his dominant language was the easiest for him to initially recover, especially using Chinese orthogaphy as visual referents. I worked with the family, used a tape recorder, phonetics, etc. and as his language expanded worked to find an interpreter to help. The man recovered fluent Mandarin and English.
I worked with another child who sustained a brain injury when leaving Viet-Nam as the war ended. She was only 7, and of course she spoke no English. I worked with her family, initially working in Vietnamese. Imagine the wonder of receiving a letter from her years later, after she graduated from medical school! She expressed in her letter than one of the greatest gifts she’d ever received was a lady who help her talk to her family again, in a new country. Communication is vital part of any family’s life. . . and I feel we are professionals who are supposed to assist our patients/students with compassion and respect for their cultures and choices. Kaye

Very interesting article, I have been teaching English students wit DS and MMR as a volunteer just to check how much they are able to acquire through only playing. I would like to ask whether it is enough to have just 7 students. I wonder if the results will not be too poor to show anyone?
Magdalena